Pediatric emergency care
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Pediatric emergency care · Jan 2022
Case ReportsAn Insidious Cause of Abdominal Pain in a Preschooler Girl: The Asynchronous Bilateral Ovarian Torsion.
The ovarian torsion (OT) represents one of the most misleading and challenging diagnoses for the pediatrician. Symptoms are often nonspecific, including sudden, piercing localized lower abdominal pain and tenderness associated with a palpable mass and peritoneal signs. Although the adnexal torsion is most frequently unilateral, cases of bilateral synchronous or asynchronous have been recorded; in the latter, the OT involved both ovaries at different settings. We reported the case of a 6-year-old girl who presented an asynchronous bilateral OT.
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Pediatric emergency care · Jan 2022
Sexual History Documentation and Sexually Transmitted Infection Screening for Mental Health Patients in a Pediatric Emergency Department.
Adolescents with psychiatric conditions more commonly engage in high-risk sexual behaviors and are at increased risk of sexually transmitted infections (STIs) and when presenting to pediatric emergency departments (PEDs) may be an important population in which to target screening efforts. This study aimed to determine frequency of physician-documented sexual history and STI screening in adolescents presenting to a PED with mental health-related complaints. ⋯ In a high-risk PED population, physicians documented sexual history only 27% of the time. Female patients were more likely to have a sexual history documented. In patients with sexual history indicating risk for STI, less than half were screened.
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Pediatric emergency care · Jan 2022
Radiation-Free Diagnosis of Pediatric Appendicitis: Accuracy of Point-of-Care Ultrasonography and Magnetic Resonance Imaging.
Appendicitis is a common pediatric surgical emergency, and it can often be difficult to diagnose. Computed tomography is commonly used as a diagnostic criterion standard, but herein, we describe the accuracy of a "radiation-free" diagnostic algorithm using point-of-care ultrasonography (POCUS) and magnetic resonance imaging (MRI) to diagnose pediatric appendicitis. ⋯ Using POCUS and MRI for the diagnosis of pediatric appendicitis is a highly accurate way to avoid ionizing radiation in children. In our study, POCUS is as accurate as MRI, although this is limited by being mostly done by a single provider and a high number of equivocal examinations.
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Pediatric emergency care · Jan 2022
Emergency Department Utilization and Serious Bacterial Infection Rates in Children With Renal Transplants.
Emergency department (ED) visits by children with solid organ transplants have increased significantly. Our objectives were to describe the common complaints, diagnosis, types, and rates of serious bacterial infection (SBI) in children with renal transplant (RT) who present to the hospital. ⋯ Our cohort of children with RT presented most commonly with infections to the hospital with UTI being the most common SBI. Bacteremia and significant interventions were rare. Future studies are needed to identify subgroups of low-risk pediatric RT patients who can possibly be safely discharged home from the ED.
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Pediatric emergency care · Jan 2022
Patterns of Vasoactive Agent Initiation Among Children With Septic Shock in the Pediatric Emergency Department.
The aim of the study was to describe patterns of initiation (and factors associated with delayed initiation) of vasoactive agents among pediatric emergency patients with septic shock. ⋯ Although there are perceived barriers to vasoactive agent initiation, we found no significant difference in patient-level factors between the timely and delayed groups. This study also identified a group of patients labeled as transient responders, who initially appeared volume responsive but who required vasoactive support within several hours. This cohort requires further study.